Can we talk about acne? To say it’s something that 80% of 11-30 year olds suffer from, it’s not something that you’d spot very often in the world of young adult fiction. Why is this? I’d argue that authors (and I totally include myself in this), in much the same way as TV and movie casting directors, are perpetuating the myth of physical perfection.

It might be that we do it unconsciously, but I’ve been told that my characters should be ‘aspirational’ – whatever that means. In YA, both male and female characters, if they are imperfect, often have ‘adorable’ physical flaws because this makes them relatable. So we’re talking about ‘boyish figures’, ‘lopsided smiles’, ‘unruly hair’ and the like.

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For me I think it’s wish fulfilment. It shouldn’t come as a surprise (given the year I’ve had) that I dearly wished, aged twelve, that I could be the most beautiful girl in school and that the tough-but-secretly-sensitive rugby captain would fall hopelessly in love with me. It’s sad though, that ‘aspirational’ characters do, perhaps inadvertently, exist to make us feel bad about ourselves. The flipside of aspiration is insecurity. Too much of our media fully relies on the exploitation of our insecurities to get us to buy things.

Several years ago I had the seed of an idea called ‘Pizzaface’ about a girl with acne whose life is changed when she enrols on a clinical drug trial. To be honest, I just assumed someone would have already done it. I couldn’t even imagine that title was still going free. But I looked on Amazon and Goodreads and not only was ‘Pizzaface’ free, but I couldn’t find any books about acne. If I’ve missed one, please do alert me to it.

I just didn’t understand how something so, SO common could be so overlooked. We have YA books about incest, conjoined twins and intersex characters – all wholly worthwhile stories – but something that affects hundreds of thousands of teenagers seems to have slipped through the net.

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And that brings us to Spot The Difference. When World Book Day asked me to write a novella for this year’s celebration, I knew it was time for Avery, my acne sufferer, to take centre stage. I wasn’t allowed the title ‘Pizzaface’ because it was, rightly, thought people might use the word to target sufferers. It’s not just a story about spots, it’s a story about beauty, feminism, superficiality, and the power of popularity.

It’s also a story of hope. ‘Sebavectum’, the drug Avery takes, is fictional, but similar medications do exist. I spoke to many sufferers at the research stage, and the one thing they had in common was that doctors had been kind and sympathetic to the serious problem of acne. It can, and does, get better.

Some 92% of acne sufferers report depression and 14% say they have felt suicidal because of their skin. Acne is no laughing matter and I really hope Spot The Difference starts a conversation about something which can really crush the confidence out of young people.